"Suddenly, I saw three rolled up aces and I was in late position. It was a 7-card stud game, not at home, but on a family vacation in Las Vegas." This letter, from a reader in California, is fascinating for it's frankness and it is probably the singularly most interesting letter we've received from a reader. He goes on to say: "A queen to my right raised and I reraised. He called. My adrenaline was really pumping. My next card was a king and as I was grabbing for my chips; I'm sure I was literally shaking. My heart was pounding out of control, my jugular vein felt like it was about to burst, and I'm sure my face must have turned redder than the ace of diamonds. After witnessing my physiologic reaction, my opponent folded."

"By profession," the writer adds, "I am a surgeon. Prior to major surgeries I am quiet and introspective, and I excel at handling crisis situations. With other people's lives hanging on a thread, I am calm - so why do I panic over a $10 dollar bet in a card game? Ten dollars is like a penny to me, so why do I bet it like it was my last dollar?"

The writer goes on to mention that he plays poker both for relaxation as well as for the challenge of winning, but the stress of winning poses a dilemma for him. "How," he writes, "can I relax and enjoy myself when I'm that stressed over a $10 bet?"

Does any of this make sense? Why would a surgeon, who effectively handles the staccato pace of multiple trauma patients in a hospital emergency room with complete aplomb, come apart from the tensions of a mere card game? Shouldn't a poker game on a vacation in Las Vegas be child's play for a man who works in an environment where the stakes, quite literally, are life and death?

While there are many forces at work here, the least of them is the ten dollar bet. One major difference between poker and surgery is the degree of control exerted by the practitioner. The surgeon is in total command of the operating room. While surgery offers no guarantee of success, a surgeon's skill resides completely within himself. No one rolls the dice in the operating room. In poker, you make your play and await the turn of a card. That card, which can be neither controlled nor foretold, may reward your play or destroy it. Though skill wins in the long run, in the narrow confines of any given hand, the whims of fortune can rage with the force of a prairie fire.

A beginner, making all the wrong moves, is capable of beating a world-class player just by getting lucky. That's the essence of gambling. Although every move made and each decision taken at the poker table is done with all the knowledge and skill a player can muster, immediate results may bear no relationship to his skills.

Risk, that high-wire act of uncertainty, is a vital force in poker. If we all played for matchsticks, what difference would it make whether we won or lost - and what's more, who'd care? But, we're playing for money, the inestimable measure of a man's worth; therefore, something as small as a ten-dollar bet, even for someone who can easily afford it, can produce stress.

Without any tension, poker wouldn't be much fun. Our willingness to risk, to take a chance when the outcome is not entirely clear, is probably one of the factors that helps us survive as a species. Why else would we risk? Why climb mountains, run marathons, become entrepreneurs, try sky diving, explore vast and unknown frontiers, play poker, or even fall in love. All of these are high risk behaviors. They require risk and are accompanied only by the certain knowledge that the success of our endeavor is not preordained.

Risk can be exhilarating as long as it is not overwhelming. Risk, after all, is not some static point in experience. It lies on a continuum. Too little risk and there's no thrill. Too much risk can be overwhelming to the point of immobility, like a deer frozen in the headlights.

And everyone has his own level of risk tolerance. Some individuals don't like any degree of real risk. Certain forms of seemingly risky behavior are not risky at all; they merely simulate it, like a ride in an amusement park. Other forms of risk seem suicidal. The prospect of free-climbing a sheer rock face or cliff diving in Acapulco, at least for the untrained, would be incredibly stressful. Like finding yourself playing no-limit poker against Doyle Brunson and Johnny Chan with the rent money, the effect can be stupefying.

For the visitor to Las Vegas, just playing poker there can be intimidating if you're not used to it. It is certainly not your local game in a card casino where you know all the regulars. Your opponents are faceless adversaries, not friends. The game is fast, the casino loud, and everyone save you, the newcomer, seems to be completely in tune with this environment. You're trying to process so much information and extant stimuli so quickly that you are overwhelmed. Seeking harmony to calm your senses, you find only dissonance. It's stage fright. It's opening night jitters. It's the fighter who says he's nervous until he absorbs that first blow. It's the writer who can bang out a 3,000-word article in a single sitting only after he's spent three days laboring over a twenty-five-word introductory paragraph.

Sure, I'm not surprised that a $10 wager can seem like betting the rent money and that under all those pressures, losing can become intolerable. Unless a player can accept the fact that short term results are simply a scattergram and endeavor to play his best at all times, that sense of tension, welling up from an inability to control something as intractable as the turn of a card, will always be present.

But there is an out. Forget about winning. Just concentrate on playing well. Concern yourself solely with playing your best game and let the chips literally fall where they may. Some things can't be controlled, so don't bother trying. If you play your best and you're a better player than your opponents, you'll win money in the long run. It may not be in that game, on that day, or in that casino, but you'll win. Take Mike Caro's advice to heart. You're not being paid to win pots. You're being paid to make good decisions. Do it and the results take care of themselves. Take the long view and I believe you'll overcome the stresses and tensions which seem to hover around unimportant and ultimately insignificant short-term decisions.

Next year, next month, next week, it won't matter at all whether you won or lost with those rolled up aces, or even whether your stress level was so transparent that your opponent folded once your trembling hand reached for your chips. What matters is that you play that hand as you play the others. It is, after all, just another in a long series of poker decisions that began the first time you played the game and will continue until your deal is done.